Individual
DR. JONATHAN CARNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5050 NE HOYT ST STE 625, PORTLAND, OR 97213-2991
(503) 731-2900
Mailing address
5050 NE HOYT ST STE 625, PORTLAND, OR 97213-2991
(503) 731-2900
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
MD.60550687
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316262108
—
WA
Enumeration date
04/05/2010
Last updated
03/07/2017
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